Brian D. Vancil, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

012441 Issued in GA

Practice address

1905 Mall of Georgia Blvd Ste 1
Buford, GA 30519

Phone

(678) 714-6343

Fax

(678) 714-6345

NPI assigned

Jul 22, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mall of Georgia Dentistry

  • General Practice Dentistry
  • Buford, GA
  • NPI 1871943662
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1699796771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 MALL OF GEORGIA BLVD STE 1",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "30519",
            "telephone_number": "678-714-6343",
            "fax_number": "678-714-6345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 MALL OF GEORGIA BLVD STE 1",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "30519",
            "telephone_number": "678-714-6343",
            "fax_number": "678-714-6345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCIL",
        "first_name": "BRIAN",
        "middle_name": "D.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15883",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "012441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Velichka Uzunova
• Lisa Marie Valdez, FNP
• Christopher S Valentine, M.D.
• Shelby Renee Valentine
• Valere Medical
• Priya Varghese, MD
• Yvette Vargovich, OTR/L
• Karen Andrea Vega Rojas, L.AC, DIPL OM
• Victory Medical Services LLC
• Vida Care LLC

• General Practice Dentistry in Buford, GA
• Providers in Buford, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.